“Dry Needling”: An Acupuncturist’s Perspective

May 26, 2015

“Dry Needling” is a term used by physical therapists, chiropractors, and some medical doctors. It is a procedure in which solid needles are inserted into trigger and motor points of muscle bellies with the intention of resetting the muscle, improving function, and decreasing pain. Since these needles are not hollow and filled with an injectable substance, they are called “dry needles.” That sounds a lot like acupuncture, right? In fact, these practitioners are using the same needles as licensed acupuncturists. Because they are billing the procedure as “dry needling,” they are able to get paid from insurance even though they are not licensed acupuncturists (L.Ac.).

I have several problems with non-licensed acupuncturists inserting needles into patients. One is of public safety. In the state of Maryland, physical therapists and chiropractors are able to needle patients after as little as 40 hours of training – sometimes even after a weekend course. In contrast, we did not even touch a needle until the second year of acupuncture school, after the foundations of Chinese Medicine were established. I can only imagine the backlash if acupuncturists were allowed to take a weekend course in manipulations and adjustments and began popping and cracking patients into alignment on Monday morning.

Besides clean needle technique and knowing the proper depth and angle to insert all needles to avoid damaging internal organ systems and structures, there are safety issues in regards to the constitution and condition of the patient. Strong needling techniques can have unwanted consequences especially in vulnerable populations like cancer patients or pregnant women. Another concern is of efficacy. I’ve been starting to hear reports of patients who tried dry needling, but it didn’t work, it was too painful, or the symptoms returned, and are therefore hesitant to try acupuncture. As Lonny Jarrett, a well-known and respected figure in the Chinese Medicine community says in regards to patients who have had dry needling and think they’ve had acupuncture, “It’s like going to KFC and saying you’ve had chicken.”

Dry needling is just one form of acupuncture. I tend to not use it often in my practice, because I have found that other techniques elicit better outcomes. I also know of very successful licensed acupuncturists who use a lot of this trigger point needling now being incorporated as “dry needling” by non-licensed acupuncturists. I think their results tend to be impressive because of their background knowledge in Chinese medicine, qi, blood, yin, yang, channel theory, etc., as well as their number of clinical training hours. They’re not simply a “needle technician.” Further, a muscle might indeed be knotted up and tight, and releasing that muscle might provide relief. But why are the tissues so tight and bound? Is there a pattern of blood deficiency in which the tendons, sinews, and muscle tissue are not nourished, supple, and emollient? Is there a pattern of qi stagnation where strong emotions or stress tend to precede bouts of tightness and pain? If the underlying reason that caused the muscle to become so tense in the first place isn’t addressed, that relief is not likely to be sustaining.

My advice to patients: Continue to go to your physical therapist for exercises and other related therapies. Go to your chiropractor for adjustments and other manual manipulations. Go to your acupuncturist for needling and for an individual assessment and treatment plan for your presenting injury or symptoms. If your physical therapist, chiropractor, or medical doctor suggests dry needling, I would consider seeking treatment from an acupuncturist instead. If there are no local acupuncturists in your area, inquire into the training of the practitioner. You might be surprised just how little training they have.

At the very least, I would recommend that any physical therapist or chiropractor have the same minimal 200 hours of training as a medical doctor who is certified in acupuncture. For a unique perspective on the topic, I encourage you to read this well-written piece written by a licensed acupuncturist who took a 3-day dry needling course: http://www.liveoakacupuncture.com/dry-needling What has been your experience with dry needling? What do you think about this topic? I would love to hear your thoughts, comments, or feedback in the comments section.

I had this done for my hip pain and not only did it not work now I am in worse pain than before! I am also having weakness in the muscles on the lower end of my leg. I am in such pain walking is horrible now.
I had a total hip replacement in 2014 and recovered in record time. Started having pain 5 months ago in front of thigh and muscle knotting up. Tried therapy and dry needling no help.